OCD: It's Here to Stay - TopherWood

I read something recently explaining obsessive-compulsive disorder and theories of treatment.  In part of the explanation it says that the person has a behavior and believes that if they do not continue this behavior that something bad will happen.  Part of the treatment stated that if this behavior is stopped, and the person recognizes that nothing bad happened, they may be able to stop the behavior.  I’m not going to go into much detail about this, but it is referring to positive and negative reinforcement and positive and negative punishment.

This theory involves negative reinforcement.  By decreasing the behavior which results in a positive outcome (nothing bad happened), this behavior should continue to be decreased.  The problem with this is that even though it makes sense, it doesn’t work that way.

Again, without going into detail, I will try and put this in a little perspective and explain this a little.  I will use the example of checking a locked door a certain number of times.  This book made it sound like someone with OCD checks the door a certain number of times because the feeling is that if they don’t, perhaps someone will break into the house because the door was not fully locked.  At least in the mind of the person with OCD.  The problem is that someone with OCD does not really think that way.  Instead, this person checks the door a certain number of times with the mindset that if they don’t, anything bad that happens may have been a result of that.

Let me explain a little more with an example.  I check the door four times when I leave the house.  I know after the first time that the door is locked, and I know that it doesn’t matter how many more times I check the door, it will not be more locked than it is.  But, however, if I only check the door once and I were to trip and fall at some point in the day, this gets traced back to the fact that I only checked the door once.  Even though I know that one has nothing to do with the other, there was a change in my routine and something bad happened.

For this reason, subtracting one compulsive behavior does not remove that behavior completely.  If I stop checking the door, another behavior will be added.  It could be counting another set of stairs or quadruple checking that the headlights are off in my car.

The bottom line is that we know this behavior is irrational, but we can’t change it.  And if someone who does not have OCD thinks that it is obnoxious, please have patience with us.  Don’t get frustrated because they are checking the door again when you are already late, or they are taking a long time to wash their hands.  And keep in mind that if you interrupt their behavior, they may be forced to start over.  If you think that it is irritating to you, think about how we feel.  We are the people who have to live with it ALL of the time.